[ExI] What Kind of Health Care System is That, Again?

[PJ Manney]

On Wed, Apr 9, 2008 at 5:29 AM, Stathis Papaioannou <stathisp at gmail.com> wrote:
> Well, Damien has more right to offer criticisms than those of us who
> have only had experience of one or other system. Anyone else out there
> who has lived in the US as well as in another country who would like
> to comment?

I lived in New Zealand for seven years and I can say from our own
experiences in two different national healthcare systems that the NZ
system is greatly preferable to the US.  I gave birth to two children
there by cesareans, with difficult pregnancies.  My husband had
photorefractive keratectomy done there by one of the world's leading
eye surgeons who perfected the technique, who just happened to work in
Auckland.  His eyes were not "textbook" and needed a more complicated
procedure and he was thrilled by both the doctor's care and the
results.

My entire family benefited from the New Zealand system, which was in
the process of shifting during our time there (1993 - 2000) from a
completely public system to a private-public mix. We had opportunities
to use both systems and I can't say one was superior to the other,
except in the post-op childbirth area and that was because of very
specific public post-natal nursing issues, but I hear the public
birthing system has greatly improved in the decade since I used it.
To be fair, the problems were no worse than I'd encounter in the US
system and the cost was dramatically lower -- for instance, my
c-sections were one-tenth the cost the same procedure would cost in
the US and my husband's eye surgery was one-fifth.  This was back in
the late 90's.  I'm sure the cost discrepancy would be even larger
today.

Moreover, the NZ pre-natal and well child/pediatric care is second to
none, especially through their Plunket system of early childhood
health education and gatekeeper system.  Please note that the Plunket
society celebrated its centennial last year.  It is not run by the
government, but is a non-profit with close ties to the public health
system, working in cooperation with every hospital and doctor's office
in the country.  It's a great organization and one I wish were in
every country in the world:

http://www.plunket.org.nz//AM/Template.cfm?Section=Home
http://en.wikipedia.org/wiki/Plunket_Society

However, the public system helped by making children's doctor's visits
from birth to age 5 either free or extremely low cost.

The NZ system is extremely sensible in many ways, as are New
Zealanders themselves.  They have a gatekeeper system of community GPs
and nurses, who send you to a specialist when needed.  The specialists
were also very sensible in their use of expensive tests, technologies,
etc.  New Zealanders are by nature thrifty and ingenious.  They had to
be, living as they do at the bottom of the world and isolated for so
many years.  They also are not litigious.  I used to joke that you'd
need a video of your doctor shooting heroin before a procedure to sue
for malpractice.  These traits drive down costs.  There were times
when my selfish American self would say, "Why can't I have what I
want?"  But there was never a point where my health was jeopardized
because I didn't get exactly what I wanted.

My parents had occasion to use the NZ system as well while they
visited us.  And my blessedly libertarian parents were blown away by
the quality of healthcare.  To this day, my mother wishes she could
transplant our NZ GP and pediatrician to the US to take care of us
all.  It made them NZ system converts, to their chagrin.

If there are negative issues with health in NZ, it's because some
people don't utilize what exists for cultural/educational reasons, and
yes, this can skew to socio-economic stereotypes.  But I have yet to
see a country that bends over backwards more for the health of its
citizens and the good benefits certainly show.  New Zealanders are
some of the healthiest, most robust people I've met in my travels
around the world (BTW and IMHO, equal with Australians in this regard)
and they take the constructive benefits health gives them into the
rest of their lives.

PJ